How to Reduce Pressure Injuries in the ICU by More Than 10%
Determine whether intensive care unit (ICU) patients require a more substantial mattress than the general patient
A level 2 trauma center in the Southeastern U.S. purchased new mattresses for their facility with a “one size fts
all” approach. The chosen surface was an alternating pressure redistribution surface with a foam overlay. Two
years following the purchase, the pressure injury (PI) rates in the ICUs accounted for approximately 55% of the
total hospital-acquired pressure injuries (HAPIs). ICU patients are a special population and at a high risk for
PIs. Incidence rates for an ICU may be as high as 38%1 , demonstrating that ICUs warrant special
The hospital chose to trial several products against their facility-owned surface (Control Bed A). A static low
air loss (LAL) surface was chosen as Control Bed B and an alternating pressure LAL surface as Control Bed C. The
trial entailed monitoring 112 ICU patients during two consecutive 30- day periods. Data was collected on length
of stay, daily skin assessments, Braden Scale2 scores, and patient height and weight.
During the trial period, a total of 12 PIs developed: three PIs on Control Bed A (hospital owned), nine
Control Bed B, and zero on Control Bed C.
Control Bed C, the surface with LAL and alternation therapy, proved more effective in reducing and
HAPIs in the ICUs. The facility elected to replace all 26 of its ICU beds with the alternating pressure
surface in order to reduce the HAPI rate in these high-acuity units. In the eight months following, the
accounted for 40% of the total HAPIs—a reduction of 11%.
About the Authors
Christina Lehman, RN, BSN, CWOCN, CFCN
Christina is a CWOCN at Gulf Coast Veterans Health Care System in Biloxi, Miss.
She previously worked as a WOCN at Memorial Hospital in Gulfport, Miss.
Angela Ladner, RN, BSN, CWON
Angela is a CWON at Memorial Hospital at Gulfport, Miss. She has provided wound
care, ostomy care, education, and hyperbaric therapy across inpatient and
outpatient settings for 13 years.
Karen Egli, BA, RN, CWCN
Karen is a Clinical Liaison for Sizewise, a registered nurse, a certifed wound care
nurse, and a member of the National Pressure Ulcer Advisory Panel’s Corporate